Treatment
An open fracture is a surgical emergency. Antibiotics are started as soon as possible in the emergency room. The next steps in controlling the risk for infection are to cleanse the wound and remove as much contamination as possible from the skin, soft tissues, and bone. This procedure is called debridement and irrigation, and is typically performed in an operating room. Depending on the severity of your injury, you may require several debridement and irrigation procedures.
If your orthopaedic surgeon suspects an infection after surgery, he or she may initially treat it with antibiotics alone, but you will likely require additional surgery to clean out the infection. During surgery, the orthopaedic surgeon will either swab or take samples of the infected tissue to find out what bacteria is causing the infection. This stage of treatment may require multiple surgeries. Special drains may be placed in the wound to help rid it of pus. Antibiotic delivery systems, like "antibiotic beads," may also be used to provide higher concentrations of antibiotics.
Once the bacteria is identified, your orthopaedic surgeon can choose the most effective antibiotics for the type of infection you have. An infectious disease specialist may assist your surgeon in determining appropriate antibiotics. Most cases require taking antibiotics for 6 to 8 weeks.
A bone infection can be difficult to eliminate. It can require long-term antibiotic treatment, as well as several surgeries. In some severe cases, your surgeon may consider amputating the infected limb in order to stop the infection. Occasionally, people are required to take antibiotics for the rest of their lives.